Individual provider Active NPI

Ryan P Perry, DDS

  • General Practice Dentistry
  • Baton Rouge, LA
National Provider Identifier
1083744973
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5422 Issued in LA
Practice address
10960 S Havenpark CT
Baton Rouge, LA 70815-5150
Phone
(225) 275-5910
Fax
(225) 275-5911
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5422 LA Primary

Addresses

Primary practice location

10960 S Havenpark CT
Baton Rouge, LA 70815-5150

Mailing address

10960 S Havenpark CT
Baton Rouge, LA 70815-5150
Phone (225) 275-5910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191214000238 LA Order and Referring Only - DentistPractitioner - Dentist 1052744513

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5422LAMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083744973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10960 S HAVENPARK CT",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708155150",
            "telephone_number": "225-275-5910",
            "fax_number": "225-275-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10960 S HAVENPARK CT",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708155150",
            "telephone_number": "225-275-5910",
            "fax_number": "225-275-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "RYAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.